Achievement of long-term treatment goals in upadacitinib-treated patients with moderately to severely active ulcerative colitis: a post hoc analysis of phase 3 trial data
Bibliographic record
Abstract
BACKGROUND AND AIMS: Comprehensive disease control is an important yet elusive treatment goal in ulcerative colitis (UC). We evaluated the effect of upadacitinib induction and maintenance treatment on composite clinical endpoints and normalization of important health-related quality of life (HRQoL) outcomes. METHODS: Data from the U-ACHIEVE and U-ACCOMPLISH trials were analyzed. Clinical responders to upadacitinib 45 mg 8-week induction were re-randomized 1:1:1 to upadacitinib 30 mg, 15 mg, or placebo for 52 weeks of maintenance. The percentage of patients achieving a composite clinical endpoint (clinical remission, complete symptom resolution, and Inflammatory Bowel Disease Questionnaire [IBDQ] remission) and a composite endpoint for normalization of HRQoL outcomes (Functional Assessment of Chronic Illness Therapy-Fatigue, IBDQ remission, Work Productivity and Activity Impairment Questionnaire-Ulcerative Colitis, 36-item Short Form Survey Physical Component Summary and Mental Component Survey, and EuroQol 5-Dimension 5-Level scores) was evaluated. RESULTS: At induction week 8, more patients treated with upadacitinib 45 mg achieved the composite clinical endpoint vs placebo (6.4% vs 0.9%, P ≤ .001) and normalization of the composite HRQoL endpoint (18.9% vs 5.5%, P ≤ .001). At maintenance week 52, the composite clinical endpoint was achieved by 18.3% and 13.1% of patients treated with upadacitinib 30 mg and 15 mg, respectively, vs 4.5% with placebo (P ≤ .001). Normalization of the composite HRQoL endpoint was achieved by 24.0% and 22.3% of patients treated with upadacitinib 30 mg and 15 mg, respectively, vs 8.7% for placebo (P ≤ .001). CONCLUSIONS: Upadacitinib may help patients with moderately to severely active UC achieve complete symptom resolution, endoscopic remission, and normalization of HRQoL. CLINICAL REGISTRATION NUMBERS: U-ACHIEVE (NCT02819635) and U-ACCOMPLISH (NCT03653026).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".